‘I want to do it my­self’

That pesky rash on your baby’s bot­tom is a lot more com­plex than it looks. We ex­plore the dif­fer­ent types of nappy rash and how to treat them

Your Baby & Toddler - - The Dossier -

JUST ABOUT EV­ERY baby gets nappy rash at some time – it’s nor­mal. Re­mem­ber that ba­bies have very sen­si­tive skin. Add to that the fact that it is moist in­side the nappy, and wee and poo con­tain var­i­ous chem­i­cals that can ir­ri­tate the skin, and the rub­bing of the nappy it­self can also ir­ri­tate your baby’s skin. It’s no won­der, then, that the area is prone to oc­ca­sional skin prob­lems. Keep the area clean and dry and fol­low th­ese ba­sic sug­ges­tions to min­imise itchy bum is­sues. Your baby will hope­fully have no more than the oc­ca­sional mild nappy rash: ✓ Change nappies fre­quently, par­tic­u­larly af­ter your baby has made a poo. Wipe well to get rid of all residue. Plain wa­ter is fine, or use wipes that are al­co­hol- and fra­grance-free. Then dry the area well be­fore putting on a new nappy. ✓ Fit the nappy com­fort­ably, snugly and evenly, so it doesn’t rub, gape or pinch. Ap­ply a bum cream, which forms a bar­rier be­tween your baby’s skin and urine in the nappy.

Petroleum oint­ment (Vase­line) is a pop­u­lar ev­ery­day pre­ven­ta­tive oint­ment, as it’s not sticky or messy. White zinc ox­ide is thicker and stick­ier, which may be help­ful for ba­bies who are prone to rashes. ✓ Corn starch, an old home rem­edy, is gen­er­ally not rec­om­mended for use on baby’s bum, as it may en­cour­age a fun­gal growth. The im­por­tant thing is to main­tain the health of the skin in the nappy area with an ef­fec­tive cream.


No mat­ter how clean and dry you try to keep your baby’s bum, nappy rash flare­ups do oc­cur. When you spot the first sign of nappy rash, take steps to soothe and heal the skin.

Gen­tly wash the area – don’t rub, just use a squirty bot­tle, a jug or a sy­ringe of wa­ter to wash away any wee or poo residue. Gen­tly pat dry with­out rub­bing. It is very help­ful to let the area dry thor­oughly.

If you can, leave your baby on her tummy with­out a nappy or bum cream on, and let her bot­tom be ex­posed to the air for a while. Do this a few times a day to help air things out.

This way you’re get­ting some tummy time in while help­ing to pre­vent rashes. Don’t for­get to put a towel or a mat down first to avoid messy ac­ci­dents!

There are many dif­fer­ent oint­ments for nappy rash. A good over-the-counter oint­ment should be suf­fi­cient for a nor­mal, mild nappy rash. It is a good idea to ask your phar­ma­cist or your clinic sis­ter for a rec­om­men­da­tion.


A mild nappy rash can be un­com­fort­able, but it should dis­ap­pear quickly with treat­ment.

Com­pli­ca­tions may oc­cur when the skin, which has al­ready been dam­aged due to the rash, is now in­vaded by bac­te­ria or yeast. That’s when the rash tends to worsen and may not be quite so easy to get rid of.

When it comes to th­ese more stub­born and wor­ry­ing nappy rashes, it’s im­por­tant to re­alise that not all of them are the same.

There are a num­ber of dif­fer­ent causes, and, de­pend­ing on the cause, dif­fer­ent treat­ments. There are sub­tle dif­fer­ences that en­able you to recog­nise what sort of rash you are deal­ing with, so that you can use the right prod­uct for that par­tic­u­lar con­di­tion.


Con­tact nappy rash is the com­mon, mild rash re­ferred to above. What to look for: Flat, red, ir­ri­tated skin. When the rash is se­vere, skin will peel or blis­ter and slough off. Treat­ment: Keep the area clean, dry well and ap­ply a nappy rash cream.

In­ter­trigo is a rash that oc­curs within the skin folds around your baby’s nappy area where the skin rubs to­gether. What to look for: The rash has a red, burn-like ap­pear­ance in the creases. Treat­ment: Reg­u­lar white petroleum­based oint­ment. Yeast rash is also known as thrush or can­dida and it oc­curs when fun­gal par­ti­cles in­vade bro­ken skin. It is most com­mon af­ter a baby has had an­tibi­otics, or when a hard-to-treat rash has gone on for a long time. What to look for: A red, raised, patchy rash with dis­tinct bor­ders, mostly over the gen­i­talia but with satel­lite spots sprin­kled around the nappy area. This rash starts as small red spots that be­come more nu­mer­ous and then join to­gether. This rash can make the skin quite ten­der, and your baby might be feel­ing un­well. Treat­ment: An an­ti­fun­gal rem­edy is re­quired. There are treat­ments avail­able over the counter or they can be pre­scribed by your doc­tor. Ap­ply the cream as di­rected, usu­ally two to three times a day, and then cover with your usual bum cream.

A nat­u­ral op­tion is aci­dophilus pow­der, which acts against yeast in­fec­tions.

If you are breast­feed­ing and your baby has thrush, you will need to treat your­self, too. Often what hap­pens is that the fun­gal in­fec­tion is passed back and forth be­tween mom’s nip­ple to baby’s mouth. Both need treat­ment in or­der to get rid of the in­fec­tion en­tirely.

Im­petigo oc­curs when par­tic­u­lar bac­te­ria (strep­to­cocci or staphy­lo­cocci) in­vade the bro­ken skin. It is quite ag­gres­sive and can progress rapidly, spread­ing else­where on the body, some­times even leav­ing scars if un­treated.

What to look for: Blis­ters or red, raised patches that ooze a honey-coloured crust. Treat­ment: See your doc­tor as soon as pos­si­ble for a di­ag­no­sis. He or she will pre­scribe ei­ther an an­tibi­otic cream or oral an­tibi­otic.

Se­b­or­rhoea is an in­flam­ma­tory skin con­di­tion that can af­fect any part of the body, but can be se­vere in the nappy area. What to look for: A big, red, sharply de­mar­cated patch over the groin, gen­i­talia, and lower ab­domen. It may be more raised, rough, thick, and greasy than the other rashes and may de­velop yel­low­ish scales. Treat­ment: Hy­dro­cor­ti­sone one per­cent cream is very ef­fec­tive for in­flam­ma­tion. It should be ap­plied twice daily, but should not be used for more than a week as it can dam­age the skin.

An al­lergy ring may be brought on by cer­tain foods that ir­ri­tate your baby’s bot­tom when they come out in her poo. Acidic foods such as cit­rus and toma­to­based sauces are often the cul­prit. De­spite what you might have heard, or­di­nary nappy rash is not gen­er­ally re­lated to food al­ler­gies, so don’t start re­strict­ing foods just in case. Rather con­sult your doc­tor. What to look for: A red ring around baby’s anus. Treat­ment: Dis­con­tinue any acidic foods that you sus­pect may play a role. Breast­feed­ing moms may need to elim­i­nate foods from their diet, al­though this con­di­tion is rare in breast­fed ba­bies, oc­cur­ring more com­monly in bot­tlefed ba­bies and once solids have been in­tro­duced. YB

Nappy rash is very com­mon and is sel­dom cause for alarm. How­ever, if the nappy rash is very per­sis­tent and resists reg­u­lar treat­ment, you should see your doc­tor.

Chances are, there is a bac­te­rial or fun­gal in­fec­tion, in which case a doc­tor’s di­ag­no­sis and a pre­scrip­tion will be nec­es­sary.

Th­ese con­di­tions can also be painful and make your baby un­happy. If your baby shows other symptoms, such as fever or rest­less­ness, or if the rash is present else­where on the body, con­sult your doc­tor.

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